Iowa Court Ruling Says Doctors Can Prescribe Abortion Drugs by Video

WASHINGTON — The Iowa Supreme Court struck down a rule on Friday that would have prohibited doctors from using telemedicine to dispense abortion-inducing pills to patients in remote clinics around the state, saying the ban placed an “undue burden” on a woman’s constitutional right to an abortion.

Planned Parenthood clinics in Iowa have been using telemedicine to provide medication-induced, nonsurgical abortions since 2008, seeing it as a way to expand access to women living in the state’s many rural areas. Under the system, the first in the nation, doctors in Des Moines, Iowa City and Ames have used videoconferencing to provide the service to more than 7,000 patients in seven clinics.

In these appointments, the doctor first consults with the patient, who is sitting with a nurse and has already had an ultrasound and laboratory work. Then the doctor clicks a button on a computer screen to open a remote-controlled drawer in the patient’s exam room that contains the medicine and watches the patient swallow it.

In 2013, the Iowa Board of Medicine passed a rule requiring doctors to perform examinations in person before giving women abortion-inducing drugs, and also to be physically present when the patients take the drugs. The board members, all appointed by Gov. Terry E. Branstad, a Republican, who opposes abortion, said at the time that the drugs could cause complications and that dispensing them from a remote location was unsafe. But the ban was set aside while Planned Parenthood fought it in court.

Jimmy Centers, a spokesman for Mr. Branstad, said the governor was “extremely disappointed that the Iowa Board of Medicine’s action, which ensured women received the high standard of care that they deserve, was reversed.”

The ruling comes as conservative lawmakers in other states seek to pre-emptively ban so-called telemedicine abortions. Sixteen states require doctors who prescribe abortion-inducing drugs to do so in person, according to the Guttmacher Institute, a research group that supports abortion rights. Two more, Arkansas and Idaho, will do so starting later this year. To date, only Iowa and, on a smaller scale, Minnesota permit physicians to prescribe abortion-inducing drugs via video.

In its unanimous ruling, the Iowa Supreme Court rejected the medical board’s assertion that a doctor should perform a physical exam before administering the drugs, writing that the evidence indicated it “does not provide any measurable gain in patient safety.” Pointing to practice standards developed by the American College of Obstetricians and Gynecologists, the court wrote, “In their view, the medically necessary information a physician needs to determine whether to proceed with a medication abortion is contained in the patient’s history, blood work, vital signs, and ultrasound images—which can be accessed by reviewing the patient’s records remotely or in person.”

Four of the court’s seven members were appointed by Mr. Branstad, and three were appointed by former Gov. Tom Vilsack, a Democrat. Justice Bruce Zager, a Branstad appointee, did not take part in the decision.

The ruling also said there was “no question the rule imposes some burdens that would not otherwise exist,” adding that if the services were to end at the seven Iowa clinics where they are offered, then “women in those communities would have to travel — in many cases hundreds of miles — to obtain abortions from Planned Parenthood.”

Noting that the board, in a rule that took effect this month, “generally approves of the use of telemedicine,” the court wrote, “The board appears to hold abortion to a different medical standard than other procedures.” Mark Bowden, executive director of the board, said it did not appear to have any legal options left. Jenifer Bowen, executive director of Iowa Right to Life, said the group was “devastated” by the decision.

Cecile Richards, president of Planned Parenthood Federation of America, said she hoped the ruling would resonate nationally.

“This ruling sends a strong and clear message to politicians across the country,” she said. “Restrictions and bans on abortion are unconstitutional and deeply unpopular, and we will continue to fight them in every state.”

In medical abortions, women first take mifepristone, the drug that doctors in Iowa dispense via video, followed one to four days later by a second drug, misoprostol. They return to the clinic within two weeks after taking the second drug for a follow-up appointment. Women are eligible for the drugs only if they are nine weeks pregnant or less.

Before meeting with a doctor via video, patients meet with nurses and other clinicians — none of them doctors — who conduct ultrasounds, take medical histories, do blood tests and tell them what to expect. The doctor reviews the ultrasound, lab results and medical history, and makes sure all the patient’s questions are answered before dispensing the medication, said Angie Remington, a spokeswoman for Planned Parenthood of the Heartland, which runs clinics in Arkansas, Iowa, Nebraska and Oklahoma.

Suzanna de Baca, president and chief executive of Planned Parenthood of the Heartland, said the organization had no immediate plans to expand the number of clinics in Iowa that offer the procedure. But she added, “This certainly gives us the ability to expand if there is a need, and we will constantly monitor that.”

A version of this article appears in print on , on Page A9 of the New York edition with the headline: Iowa Court Ruling Says Doctors Can Prescribe Abortion Drugs by Video. Order Reprints | Today’s Paper | Subscribe